The sales of new morphine patches have grown explosively in Norway since they were first introduced to the market in 2005. But researchers at NTNU and St. Olavs Hospital have found this development worrying, because their research shows that these types of plasters are often used incorrectly, or based on the wrong assumptions. The consequences can create drug dependency problems.

"The reason for this incorrect usage is that there is not enough information out there, and a lack of expertise in individuals who are writing prescriptions," says Professor Petter Borchgrevink, head of the Norwegian National Centre for Complex Disorders.

Should reduce the risk

The patch works in the same manner as a nicotine patch, with the clear difference that a nicotine patch is used to reduce the craving for cigarettes, while a morphine patch is used to reduce pain. But both provide small, steady doses of their active ingredients over a longer time period.

This method of medication is best for patients who need low doses of pain-relieving medicine. In a perfect world, it makes sense: the medication could be more controlled, drug consumption could be reduced, and the risk of dependence should therefore be less.

Now it turns out that incorrect use of the patches can make problems worse, so that the effect is the opposite of what was intended.

An addition, not a substitute

The patch came onto the Norwegian market in 2005. It was the first morphine-like drug marketed for chronic pain that is not caused by cancer. But the danger of misuse was great, and Borchgrevink and Professor Stein Kaasa at NTNU decided to follow up on whether the patches were being used correctly.

The pair started a research project in cooperation with the Norwegian Institute of Public Health. Now the conclusions are clear: Instead of being substituted for another habit-forming medication, the morphine patches were often being given in addition to other drugs.

"This increases the health burden and the risk of addiction, "says Borchgrevink.

He adds that this is especially true for a large group of chronic pain patients that did not use morphine-based medications before given the patch.

Substance abuse a major risk

"For some patients, it would be appropriate to give morphine-like drugs for strong chronic pain", says Kaasa, who is a specialist in pain relief medicine and director of NTNU's research group on cancer and palliation.

"The big challenge is to avoid backsliding when it comes to medical indications for the use of the drug; in other words, we don't want the drug to be given to patients who do not need it. Experience from other countries, including Denmark, shows that the large consumption of morphine and similar drugs by people with chronic pain that is not caused by cancer can provide significant problems with addiction."

For these patients the use of the patch can amount to substance abuse, and many end up with major addiction problems. Patients who use multiple addictive medications at the same time are particularly vulnerable, Kaasa says.

Significance for other countries

The study was conducted in connection with the Prescription Registry, which was created by the Norwegian Institute of Public Health in 2004. The researchers wanted to find out which patients were being given prescriptions for the patches, and how many got them. They also wanted to know what other kinds addictive medications the patients were using in addition to the patch.

Professor Svetlana Skurtveit at the Institute of Public Health said that half of all patients were given more than one prescription. More than 90 per cent had used morphine-based medicines before. More than 60 per cent continued to use other drugs in addition to the patch, including morphine preparations and other types of addictive medicines.

"In the course of a year, sales doubled, and they continue to skyrocket", Skurtveit says.

The study was published internationally and has received considerable attention. "Our findings may have special significance for countries that don't yet have a morphine patch on the market", says Skurtveit.

I am a chronic pain patient, who is very familiar with the world of opioid & synthetic opioid pain medications. The Fentanyl Patch is a synthetic opioid. It is not morphine. Unfortunately, there is no morphine patch, which is disappointing because Fentanyl can be much more cognitively and physically impairing. Morphine manages pain nearly as well, yet taken in it's traditional form, tablet, can often lead to nausea/vomiting, bowel and urinary tract issues, rebound headache/migraine, itchiness, and insomnia, aside from prolactin swings, weight gain/loss, dizziness etc.

I have been using Morphine Patches for over a year now for extremely painful micro-fractures in my pelvis. I feel quite well on them, sleep well, have no nausea, dizzyness or other symptoms, and find they do not upset my stomach like strong pain killing tablets do.
I do get occasional constipation, but that is easily cured with Senna.
I am extremely creative,writing, painting, knitting, am active, walk frqwuently and my body and brain seems to be fine on these patches. i certainly don't feel drugged up in any way. They might have a bad long term effect, of that, i have no idea, but so far so good.
I take an occasional Ibuprufen tablet on top of the morphine, low strength, but no other pain killers.
I give thanks for the pain relief, and have lowered the dosage from 20 grms to 15 grms, but though I have tried to go down to 10 grams, I usually find i need to go back ip to 15grms due to pain.
If and when i can dispense with these, if ever, i shall be glad, as I've never been into taking drugs, BUT, thank goodness for them as i was in screaming agony.

I am afraid to try the morphine patches I have been precribed after reading the side affects and being addicted to them I have had spine surgery I am in more pain now than beforethe consultant said he damaged the nerves can anyone advise me I don,t want to be like azombie but the pain is unbearablr regards dotty

I am a 37 year old man and I suffer from osteoporosis,fibre myalgia ,scoliosis,and celiac disease and I have just started on the morphing patches and they are giving me no side effects for the first day a felt a little sick in stomach but that past and now I feel great they are much better than tablets I think as they will not do bad things to the inside of your body so I would say give it a go it worth it Dotty

dotty if you are in a lot of pain take the morphine if you have any kind of lung problems don't it will make your breathing very bad like me ive been lied to by my gp who was giving me every month antibiotics when it was the morphine but as a pain releaf its going to do the job good luck dotty

I have been on patches 50mg for 3 years I as I don't no that much about morphine I kept putting the patches on every 72 hours for the past 3 years ive had a lot of problems with my lungs so my dr was giving my antibiotic most months it was in oct 15 I had xrays done on my lungs they came back clear but my breathing was still poor so I started to look up morphine on pc and was shocked to see it say that morphine was very bad for people with lung problems which I had since I was a child so I went to my gp and told him I wanted off this morphine he said its not the morphine its copd I had I told him I want to get off it and I want to start now so he took me of the 50 mg for 25 mg and gave me tablet form 10 mg 2 morning and 2 at night for the first 2 days I was fine but then was feeling very ill and I went to the pharmacy and told him how I was feeling and he told me I was over doseing I showed him the med and he was shocked he told me to half the dose in tablet form you no I stopped the tablets all together as I was ill with it and now I was getting the side affects from the morphine for about a week went back to see my gp and he gave me a mouthful you are disrespecting me my wife was in with me I said look this is my life my breathing is much better and I'm feeling a bit better he didn't want to say the morphine was restricting my breathing but then said its on the notes altogether ive been on morphine for eight years 3years on the patches and its caused me so many problems I wish I had never see it in my life but now he said we are getting you off the morphine sorry I'm getting me off it and without any help he said to me today he wont want to give me pain releaf now because I had it out with him about how it was making me feel so I may have to seek some help from someone who knows better than me

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